144. Healing Pelvic Floor Dysfunction Beyond Kegels

Are you dealing with bladder leaks, pelvic pressure, constipation, or that nagging feeling that something just isn’t working the way it used to? If so, you’re far from alone. Pelvic floor dysfunction affects millions of women, especially during perimenopause and menopause, yet many are told their only options are Kegels, invasive treatments, or simply learning to live with it.

In this episode, I’m joined by physical therapist and Tighten Your Tinkler co-founder Christina Walsh to discuss a different approach. Christina shares her personal journey with pelvic floor dysfunction, the surprising lessons she learned through her own healing process, and how women can begin supporting their pelvic floor naturally through functional movement, nervous system regulation, and simple daily habits.

If you’ve ever felt dismissed, frustrated, or unsure where to turn for help, this conversation offers hope, practical tools, and a reminder that healing is possible.

In this episode:

[02:17] Christina shares how her own experience with pelvic floor dysfunction and pelvic organ prolapse led her to create Tighten Your Tinkler

[04:18] Why Christina and her co-founder faced resistance when bringing their non-invasive approach into traditional medical settings

[06:12] The functional movement method that helps women improve pelvic floor symptoms without relying on Kegels or invasive devices

[07:05] The connection between the nervous system, muscle tension, and pelvic floor dysfunction

[08:44] Why many women don’t find relief from Kegels—and what may work better instead

[10:19] Simple toileting posture changes that can reduce strain and support pelvic floor healing

[12:38] The often-overlooked role of hydration and electrolytes in bowel health and pelvic floor function

[13:15] Christina explains her free at-home decompression position and how it can help reduce pelvic pressure, tension, and discomfort

[16:05] Why learning to listen to your body may be one of the most powerful tools for long-term healing

[17:40] The unexpected whole-body benefits women often experience when addressing pelvic floor dysfunction at its root cause

[18:58] How Christina’s Root Cause Quiz helps women identify symptoms, connect the dots, and determine their next steps

[20:29] Resources, support, and practical tools available through Tighten Your Tinkler

Connect with Christina Walsh:

A physical therapist and New Orleans mama of two living with pelvic dysfunction, Christina Walsh understands the power of transforming pain into purpose. Together with Tighten Your Tinkler cofounder Jenn Lormand, Christina helps women with pelvic floor issues find healing without Kegels or invasive devices. Drawing from her own vulnerable story and decades of professional experience, she delivers actionable advice mixed with a message of hope.

When she’s not supporting the Tighten Your Tinkler community online, Christina loves experiencing local New Orleans culture with her family, avoiding makeup (unless it’s Mardi Gras), and laughing with friends.

Website: https://www.tightenyourtinkler.com/

Instagram: https://www.instagram.com/tighten.your.tinkler/

YouTube: https://www.youtube.com/@tightenyourtinkler

5-Minute Root Cause Quiz: https://www.surveymonkey.com/r/tinklerquiz

At-Home Decompression Position: https://www.tightenyourtinkler.com/backandhiprelief

Coupon Code: RENEW for $50 off the Tighten Your Tinkler Signature Program.

Connect with me, Sara Poldmae:

·       Website: https://risingwomanproject.com

·       Instagram: https://www.instagram.com/drsarapoldmae

If this episode resonated with you, I’d love for you to share it with someone who needs to hear it. Don’t forget to follow, rate, and leave a review—it helps more women find this space so we can all rise and thrive together

If you've been craving a real reset, I'd love to invite you to join me in Tuscany this October for Restore Again in Tuscany, a small-group wellness retreat designed to help you reconnect with yourself, restore your energy, and experience the beauty of Italy alongside an incredible community of women.

Learn more here:
https://www.wetravel.com/trips/restore-again-in-tuscany-restore-studio-at-meadow-hill-wellness-3989113364#about-this-trip

Transcript

Sara Poldmae: 0:01

Sarah, welcome to Menopause Rise and Thrive. I am Dr. Sarah Poldmay, and this podcast is your go-to guide for navigating perimenopause and menopause. If you are feeling a little overwhelmed, trust me, you are in great company. Each week, I'll bring you expert advice, raw, honest conversations and simple tips to help you stay grounded and maybe even find some humor in the process. Let's rise, thrive, and tackle this wild ride together. Hello, everyone. Welcome back to Menopause Rise and Thrive. Today, I am joined by Christina Walsh. Christina is a physical therapist and a New Orleans mama of two, living with pelvic dysfunction, and she understands the power of transforming pain into purpose. So she co-founded Tighten Your Tinkler with Jen Lohrmand, and Christina helped women, along with Jen, with pelvic floor dysfunction issues to really find healing without key goals or invasive devices, Christina draws from her own vulnerable story and decades of professional experience to deliver actionable advice mixed with a message of hope when she's not supporting the Tinkler community online. By the way, I love that Christina loves experiencing local New Orleans culture with her family, avoiding makeup unless it's Mardi Gras, and laughing with friends. Welcome to the show. We're so excited to have you.

Christina Walsh: 1:32

Thank you, Dr. Sarah, and thank you for the work that you do in the world. I mean, this isn't why we're here technically, but I could just go on and on about the way that my acupuncturist has helped me heal in this stage of life in ways that I don't think anyone else could, and when using methods that I far prefer to the other options that are out there. So, just thank you first.

Sara Poldmae: 1:53

Absolutely. Well, you're very welcome. I have actually stepped out of the acupuncture space, but I have amazing acupuncturists at Meadow Hill, that are carrying on that work, and I still definitely use Chinese herbs quite a bit in my functional medicine practice, because it is really, I believe, that acupuncture and Chinese herbs are the original functional medicine, looking for the root cause and really unearthing why we have these issues to begin with. So,

Christina Walsh: 2:17

I think you're right, not why we're here, but thank you for saying that, and I always love to tout my own medicine, but we're going to talk more about your medicine. So, how can you help women with pelvic floor issues? My partner, Jen, and I were led here by our own personal experience, like so many of us, right? We end up in these positions for these reasons of walking this path ourselves, and our stories are very different, with five very different birth stories, but we both ended up needing help to heal from pelvic floor dysfunction, mild to moderate pelvic organ prolapse. We had tried the other options that were out there, like Kegels, Jen was referred for a major pelvic reconstructive surgery at 36 The doctor looked her in the eyes and said, and I hate doing it on women this young, because I'm just gonna have to repeat it in 10 years, and the two were like, no, this is not gonna be our story. So, you know, thankfully we were already an exercise physiologist and physical therapist duo, working under one roof as separate businesses, taking care of moms when we had to figure out our own stuff, and so we went on a path to find another way, because right, because what we were pitched, what we tried, or what we were offered, either didn't work or wasn't what we wanted to do. So, thankfully, we did find another way that's fully non-invasive, not Kegel-based. It's functional movement, it's a holistic approach, and it worked for us. And we were like, oh my gosh, we started using it with women in our clinic, and it worked for them. And then we were getting all these testimonials, and we were like, we have to get this out there into, like, the medical system, they need to know about this. And so we took on the crazy mission of doing a university research study to test our protocols with data, like, that's what the doctors will listen when we have data, right? So we did three years of university research, got published in a peer-reviewed medical journal, and we thought that's it, they're gonna, they're gonna jump at this, they're all gonna be so excited, and we went to urologists and urogynecologists, and they basically were like, we don't want to have anything to do with this, like, how did they

Sara Poldmae: 4:17

say why,

Christina Walsh: 4:18

no, no, they put us off, they listened and smiled and nodded, and we never heard from them again. They put us off, they ignored us, they didn't call us back, and we still don't know why or what happened, but you know the approach we're taking is outside the system, and it's not going to make the system a lot of money. I'm not a conspiracy theorist, but I really had to wrangle with why were we so rejected, you know, and so, bottom line is, women in our research came back to us and started asking for access to refer women that they knew, because they're like, everyone I know needs this, like all these women I know in other states, they can't get here, and so we took that as a sign, like, between being rejected by people kind of in the system, and then these women begging us to make this success. Possible, we were like, we have to listen to these women, and so that's how Titan Your Tinkler was born. And we are research and clinical nerds for what we do. We did not come up with that name ourselves. We let one of our clients help us. It didn't sound too clinical and boring. Our tagline is silly name, serious results, because we don't take ourselves too seriously, but the issues we're helping women with, and that we helped ourselves with first, are utterly life-altering. If you feel broken at your center, and I always get emotional when I talk about this, I've looked at when you feel broken at your center, you cannot feel well showing up in all the roles in your life that matter most to you, to your spouse, as a friend, to your kids, if you are constantly planning your life around these issues, whether that happened suddenly from a birth experience or a transition into perimenopause, or whether that happened gradually over years and years, and slowly you've just lost more function, and your bubble has gotten smaller of what you can and cannot do, feeling okay, no matter what. When you find yourself there, you're carrying a weight around that you may not even realize how heavy it is until it starts to lift, so this stuff is better

Sara Poldmae: 6:08

approach. Then, what is what is what is this approach,

Christina Walsh: 6:12

totally? So, we went to a continuing education course, Jen and I did, trying to figure out what else was out there, and we encountered another physical therapist who was already training other PTs with this external exercise tool. It's a ball in a band, right? It's not high tech. You don't need a, you don't need to shove it up into your body. You're not awkwardly squeezing anything. And we took her tool and dialed it into a 10 minute day functional movement series. So, if and when you choose to work with us, you walk through self-assessments to be like, where am I starting from, and then you walk through some relief techniques, so you're going to put yourself in some kind of anti-gravity postures, some relief postures to down regulate your nervous system, because that is always a part of all these pelvic issues as well, but yeah, you know, so

Sara Poldmae: 6:56

my patients think, oh, I'm just weak down there, but it's so much common that you're actually in like muscle spasm, like, yes, kind of contracted,

Christina Walsh: 7:05

yes, absolutely. So, a huge part of this approach is non-invasively and non-painfully, we're going to teach that nervous system connection that it, you are safe, that we're going to put gravity on your side in some relief positions, we're going to teach you how to use better toileting postures. Some of this we can start to go over and get you moving in the right direction with today. Some of this stuff is so easy and accessible, but to walk you through the whole approach, you learn the relief tools. So you, it's like strap on a tool belt of relief tools you can call on and start to move things in the right direction immediately, and that set your pelvic floor and your nervous system up for healing, just with that gentle nudge, right? It doesn't have to be aggressive, it doesn't have to be invasive. Our bodies are designed to heal, and sometimes we just have to, like, give them that. I mean, that's what that's what Chinese herbs are about, that's what functional medicine is about. I said it's very aligned, so I was like, oh, this is going to be a great conversation, because we already believe in such a similar approach to how we encounter the body, and then we add the functional movement series, it's triplanar movement, it's whole body movement, and the thing that most programs are missing that this gets, and this is why it felt so different to us, is it activates the muscles again, you can't strengthen a muscle that can't turn on in the first place, right, right, so this functional movement series gets the muscle to turn on subconsciously again. That's why Kegels also don't make sense, right? Like, the women who end up working with us are like, either they tried that and it didn't work, it made things worse, or they intuitively are like, this doesn't make sense, I've never strengthened another muscle this way in my life, and you're right, it doesn't make sense, it's what's been offered, because it was the best thing that was out there, and look, if that worked for you, like

Sara Poldmae: 8:43

super great,

Christina Walsh: 8:44

that is awesome. Like, I'm not here for you, I'm here for all the hundreds of 1000s of women who did try it. It didn't work, it made things worse. They don't want to go down that route, they don't want to penetrate their bodies with foreign devices, they, or they have young kids, they can't get to another dog on appointment, or there's not a therapist in their area who they can even work with, so that's who I'm talking to. If that's you, you know, please know there's hope. There is absolutely hope for healing, and it doesn't have to be hard, like that's the other thing. When you give your body that little nudge that it was of the direction it was trying to go anyway, right? It doesn't take a lot of force, you know, and it's

Sara Poldmae: 9:20

some things that you could take away today. Do you have a couple of toileting techniques that you can tell our listeners that they can take away today to kind of start this process, so that they may be more inclined to like check you out and find out more about this functional approach? Because I absolutely love this, and there's, you know, a lot of women - I'm not going to say this lightly, there's no way to say it lightly - but a lot of us have experienced trauma. So, the idea of going in person to a pelvic floor physical therapist, I think it's the right idea for a lot of women. Yes, it doesn't mean a lot of women are receptive or open to that. It's scary for a lot of, yeah, especially. Layer on trauma, so I am so into the idea that they can do some of this at home and learn these tools in a more virtual way until they're maybe ready for that next step, or maybe they won't need it, but at least give us some things that they can start with to get them excited about your particular approach.

Christina Walsh: 10:19

Absolutely, well, I love the what we say down here in New Orleans is you do you boo, so like what you said, like I love that there are options now for women, so it is like this is very personal stuff we're talking about here. So first of all, like turn inward, know yourself, like if you are the type of person who needs that in person care, go receive it absolutely, but but if you're the type of woman who's drawn to that functional holistic approach, being able to do it from home with your clothes on. Then, yes, go down our rabbit holes, like we've got all the deep dive teachings on YouTube, we're all on Instagram, and everything like that. But in the meantime, start moving things in the right direction today by doing something as simple as adjusting your toileting postures. Right, the pelvic floor is responsible for peeing, pooping, and penetration, to put it succinctly. So every time you take care of your body gently, while you're doing any of those things, including peeing and pooping, you are pouring healing, caring kindness into that part of your body that needs heal. So if you're not already, get yourself a toileting stool, a squatty potty, put yourself in that ergonomic position for emptying, which will eliminate that feeling of needing to strain every time you strain or push, you are adding downward pressure to a system that may be already compromised. So don't push your pee out, relax to let it out. Put your knees up higher than your hips, so you're in that ergonomic position. Exhale as you go, and if you're a woman who may or may not be struggling with complete emptying, and I mean, if bowel or bladder, try swaying back to side side as you go. Also, rotate your trunk in circles forward and back to kind of realign everything that may have been kind of smooshed into the wrong position in that pelvic bowl through birth trauma, exhale, breathe, circle back and forth, wave back and forth of your trunk, left, right, forward, back, have those knees higher than your hips. If you can empty more passively, more peacefully, bowel and bladder that way, every time you do that, it's a gift to your pelvic floor to encourage healing, and at the same token, as you always talk about, hydrate with electrolytes. Don't just hydrate, because when you're hydrating with electrolytes, your body can make better use of that water. It's not just running through you, and when you have well-hydrated stool, it passes smoother and easier to begin with. So, less,

Sara Poldmae: 12:39

I forget every day that people aren't high, like I know I shouldn't forget, and I feel like, gosh, Sarah, you hear it every day, like, why can't you get it through your.. but I have patients that are chronically constipated, and I ask them, are you hydrated, blah blah blah, and then you know, three weeks later, after having that conversation a couple of times with them, they come in and they say, yeah, I drank like three really, really big bottles of water today, and I used electrolytes, and one of them, and I really started pooping well. So, I think I'm going to do that more often. I'm like, oh,

Christina Walsh: 13:11

it feels so much better.

Sara Poldmae: 13:13

This stuff up, yes.

Christina Walsh: 13:16

And it, everyone, at every time you do that, it's a gift to your pelvic floor, so especially if you're dealing with issues down there, do these things and make sure to get our free at-home decompression position. This is a position you don't need any special equipment. This is one of the tools pulled out of our program that's a fan favorite. You're going to lie in this position at home, no special equipment needed. There's a video, a PDF to teach you and walk you through it, how to optimize it, and you know, tweak and adjust it to get it right for your body, and you're going to put gravity on your side. This is going to decompress your back, your hips, your pelvis, and your nervous system in 10 minutes. You're going to feel like that, almost that relief, like after you got a great massage, where your body just exhales, and you put on your favorite podcast, and you listen to Dr. Sarah while you're laying there, or you meditate, you know, and so your rest multitasking. Look, I know I'm a doer, we're all busy working moms, right? So this is rest multitasking. You were doing so much for your body in that 10 minutes, and when you do this, like before bed, and you realize you actually slept better too, trust me, you're going to want to come back to it. So I make sure you have the link for that free at-home decompression position. That is a gift to start giving to your pelvic floor. If you're one of those women you suspect, like maybe I do have that over tight, that guarding, that spasming situation going on, which so many of us do. This is a huge gift. Start giving your body every single day, and so that's another easy thing you can do. Another easy thing you can do is just listen, like sometimes we've had to disconnect from how this feels and be like really centering in it, because we were in a survival place, right? We had to keep going for our small children, for our business, for the house that was crumbling, I. At a really old house I've lived that, so but now is the time, maybe to tune back in and allow yourself to listen to what your body's telling you, and the kind and compassionate healing choice is to stop pushing through it. You're not doing yourself any favors when, like, the leaks are triggered by an activity, or maybe the pressure gets worse by something that you wear that squeezes you around your middle, or you're not doing yourself any favors to keep doing that thing. Now is not the time to power through and think that's going to just get it better, because that's not what's going to happen. You're looking, the sooner you can do something about it, the sooner you can start making these compassionate choices, pouring care into your center again, the sooner the better, because there is a place, there is a threshold after which conservative care, it won't be enough anymore, and I don't say that to be alarming, I say that to take care of you and wrap you in that warm hug of so many women in our YouTube teachings, the hundreds of comments of women going, I am in tears right now. Why did no one tell me this? No, what are you

Sara Poldmae: 16:05

hearing you saying is, and I think it's such a gift. So, Christina's on my podcast, talking about pelvic floor issues and her approach to it, and one of the biggest parts that I'm hearing from Christina about her approach is something that resonates so deeply with me. It's part of why I started Restore Studio, because restorative yoga really brings in a lot of breath, and Christina is, is talking about, you know, when you're actually using the bathroom, do you even breathe? Can you allow your body to soften into something that women are so, so used to rushing through, you know, I always joke like men need 20 minutes in the bathroom. Well, maybe we can learn from men. I don't say that often, you know. I think that men should be listening to us more, but this is maybe the first time I've ever actually said that in my life. But the idea of let's not rush through it, let's breathe, and most importantly, Christina, the one thing I've really loved listening to you say is listening to your body, because all of these symptoms that we're experiencing, whether it's a pelvic floor issue or any other issue in your body, don't push past it, try and see where the connections are, right, like what is causing this, because sometimes we go to outside sources to try and figure it out, but the answer might be there. It might be something that you're not enjoying doing, and your nervous system just says and frees, and so then we're left with these patterns, these repetitive use patterns, or this repetitive holding that can cause real issues,

Christina Walsh: 17:40

and it's sometimes it's just, and it becomes the downward spiral at that point, but what we, when you start to pour in gentle care, it can become that upward spiral of healing again. You know how it is when you start to heal the body holistically, addressing things at the root cause. The beautiful thing is that the side effects are only positive. Yeah, you know, like women come back and they're like, I've been doing this for three days, and on my posture is better, like I didn't know that was gonna happen, or like I'm having more feeling with sex again. I didn't know that was possible for me. I'm sleeping through the night again. I came for leaks, I came for the pressure, but now I'm not getting up to pee anymore either. And now my waistline is cinching in, and now my booty is a little perkier, and like right effects only become positive when we take that holistic root cause approach, and that is also the absolute beauty of all this. So, if you're wondering if this is you, take our five minute free quiz, that is the best place to start with us. When in doubt, if you're like, if you intuitively feel like you might have some pelvic floor issues, you're not sure if they really are pelvic floor issues, you'd like to know, actually, how bad is this really on the spectrum? And what are my best next steps? If you're just.. and that is a great addit. Approach your body with curiosity right now, approach it with compassion, listen and learn, and you will then be led down the path to find the healing approach that is right for you, whether that's with us or us or not, I don't care, but listen, tune in, and take that next step, and that five minute quiz is a perfect place to start, because it will give you that research validated answer about what next steps are best for you, based on the data that we collected, we will point you in the right direction, give you more resources to keep going down those rabbit holes to figure out where do I need to go next, am I ready for this next step, and what can I continue doing and start doing to move things in the right direction for me. And as you take that quiz, you'll also have a quick five minute experience of a lot of validation and dot connecting, so if you've been at all working through the Western medical system, in regards to any of these issues, you'll find that they like to put them in very separate little buckets, right? And that's not really what's going on here, right? So many women take that quiz and they're like, I intuitively thought that, like, this issue was connected to this one, but my doctor said that I, that couldn't be right, and I was wrong, but I knew it. And that's so in five minutes you'll get direction about what your next steps can be, and you will also get that validating dot connecting experience of going, okay, this stuff is all connected, and I knew that

Sara Poldmae: 20:14

I love it, I love it, I love it. So, can you please tell our listeners exactly how to get in touch, spell out your website, all that good stuff, so that we can make sure if they're ready to get started, they have the information that they need.

Christina Walsh: 20:29

Girl, it's just.. it's tighten your tinkler everywhere. We are tighten your tinkler.com we're at tighten dot your dot tinkler on Instagram, and it's tighten your tinkler on YouTube. And again, if you feel called to learn more about any of this. We take great care to make sure that women feel the way that we wanted to feel when, when we were learning all this, that we want to make sure you feel hope, that you feel taken care of, and that you feel like your hand is being held on to that next step, because this stuff is so much more than just physical. And

Sara Poldmae: 21:01

that quiz was amazing. I have to say that even though I'm board certified by the Menopause Society, I have done my homework. I think I know a lot about the pelvic floor. Reading that quiz and the descriptions of some of the things that women are suffering with made me gasp out loud, me made me even more empathetic than I already am towards my patients, so yeah, it's something that I think there can be a lot of emotion around, including team, etc. etc. So being able to reach out to you will be invaluable for some of our listeners, I'm sure.

Christina Walsh: 21:37

Absolutely. And start with that quiz. When in doubt, you're welcome to email us too. There are not robots. We are a tiny little team of working moms, and we love nothing more than taking care of you and meeting you wherever you are, and pointing you in that right direction. So, you can also email us hello at tighten your tinkler.com But start with that quiz when in doubt.

Sara Poldmae: 21:56

Thank you so much for being on the show. I really enjoyed chatting with you. Yes, please tune in, and if you have not done so already, email me with any ideas for shows. I always love to hear from my listeners, just like Christina and her partner love to hear from people as well. We are live human beings, so we do love hearing from y'all. All right, everybody, have an amazing day.

Unknown: 22:36

Bye.